2020年1月30日 星期四

Coronavirus Is Now a Global Health Emergency. That’s Not As Scary As It Sounds.


Some prevention efforts are mostly for comfort.

(Photo by Kevin Frayer/Getty Images)

On Thursday afternoon, the World Health Organization officially declared the coronavirus outbreak a global health emergency. It’s a reverse from their position just a week ago, when they had declined to, on the grounds that the disease was mostly only spreading within one country. But that is no longer the case, as you may have seen in the breathless headlines announcing the first case of person-to-person spread in the United States, the first person to be diagnosed in India, and the news that, within China, the total number of cases has now surpassed those of SARs worldwide in the early 2000s.

Every move the coronavirus makes—or may have, potentially, made—has been documented. Some news organizations have created continually updated pages with headlines that read like ticker-tape from a pandemic movie. Thousands of people were trapped on a cruise ship in Italy after a passenger who’d flown in from Hong Kong had a fever. They were held even after early tests suggested she was negative for the virus. (They’ve now been released and it’s been confirmed she has the flu.) The newness of this coronavirus, and the mayhem it has created, continues to provide a steady supply of pegs for stories.

It all sounds a little scarier than it is. In America, the number of potential cases of coronavirus “under investigation” by the Centers for Disease Control and Prevention keeps rising, currently at 92 people with pending results. And yet so does the number of people that have been determined to be negative—currently that’s at 68, with only 5 confirmed cases. That may be because the bar for a person to be “under investigation,” or a “suspected” case, is low. A cough, a fever, and a recent travel history to Wuhan, China are enough to get you in the investigation pile; if you’ve recently come in close contact with someone who has the new coronavirus, just the cough will do. Luckily, the “investigation” here involves a nasal swab, since speedy sequencing of the coronavirus genome means we already have a test to accurately check. Even if the virus is confirmed, in the vast majority of cases, treatment means riding out the symptoms as you would with a common cold; the mortality rate, still something of a question mark, seems to be 4 percent, most of them people who already are not in good health.

Still, even as scientists learn more about the new coronavirus at an astonishing speed, it’s hard to disseminate reassuring pieces of information that aren’t overwhelmed by warnings. This is one of the precise reasons WHO was hesitant to name the global health emergency, something it’s done just five times. As the New York Times reports:

Declaring emergencies is always a hard decision, said Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, because closed borders and canceled flights lead to personal hardships for millions of healthy people near the epicenter and can cause massive economic disruption.


 In the worst cases, supplies of food and medicine can run short and panic can spread, threatening to do more damage than the disease does.

The panic is indeed spreading. Multiple stories have addressed the “legitimate question” that packages shipped from China might carry the virus and therefore infect people; in Chile, health officials recommended opening them with gloves out of an abundance of caution. There’s no evidence that similar viruses—and even though the new coronavirus is new, it appears in many ways similar to other viruses—can survive outside a host for more than a few hours. The idea that it could be shipped from Wuhan to Chile seems nearly impossible. But who can say, technically, that this one wouldn’t?

Science is good at gesturing to the potential capabilities of a virus, what’s harder and takes more time is figuring out exactly what it cannot and will not do. One place where we could be overestimating damage is in early calculations of something called R0, which estimates the number of people each infected person will, on average, go on to infect. Basically it describes how quickly it could spread. The current R0 pegs it somewhere around SARS (2 to 5 people per person). But as Ed Yong notes in The Atlantic, these estimates are “not destiny,” but rather “a measure of a disease’s potential.” It’s capable of being lowered by even judicious hand-washing.

The new coronavirus is not harmless; it has killed people and will kill more. But we don’t yet know what the scope of the problem is. As we all sit simmering in the news alerts and emergency announcements, it’s useful to remember that nearly all of this is about global health rather than your own personal risk. And sure, it feels better to at least try to understand what the scope of the problem is, even if that means assuming the worst. That’s because “humans deal very badly with the idea of chance and contingency,” as sociologist Robert Dingwall wrote in Wired. Dingwall called for us to stand down with efforts like useless face masks.

That seems smart. But to simply adjusting one’s expectations to a new normal of outbreaks, as Dingwall further suggests, might be too far. Calmness is not the same as inaction. The phrasing of the WHO’s declaration might be panic-inducing: the new coronavirus is now a “public health emergency of international concern.” But the WHO declaration is more about enabling better funding to help contain and address the problem than it is about alerting the whole globe. This points to just about the only, albeit small, measure individuals can take in the face of this outbreak: They can support politicians (and policies) who care about global health and cooperating with other countries, and funding for science. Sure, it’s a slow way to enact change. In the meantime, it helps to remember that perhaps we’re so worried about the coronavirus because to worry feels like a way to engage.

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